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The Four Stages of Wound Healing

The human body is like a complex machine made up of a variety of processes and systems that contribute to our overall health.

One of these processes is wound healing which can be impacted by a number of factors such as the wound care products we use or the kind of lifestyle we live. The body, along with the factors mentioned, works hand in hand in repairing and replacing devitalized tissues.

But the real question is, how exactly does the body heal? What phases or stages does a wound go through until it fully heals?

The wound healing process is divided into four overlapping stages and they are defined as follows.

Phase 1: The Hemostasis Phase

The hemostasis phase is the first phase in the wound healing process and it starts at the onset of the injury where the goal is to stop the bleeding. It is in this phase where the body goes on emergency repair mode, turning on its blood clotting system to block the drainage.

As all of these go on, the platelets combine with collagen and an enzyme known as thrombin allows the creation of a fibrin mesh that helps strengthen platelet clumps allowing for a more stable clot.

Phase 2: The Inflammatory Phase

While the first phase is about coagulation, the second phase called the defensive or inflammatory phase, focuses on preparing the wound bed for new tissue growth by battling bacteria and removing debris.

This is made possible by a type of white blood cell known as neutrophils which usually reaches its peak population within 24 to 48 hours after the injury. As their numbers go down, a special cell called macrophages continues the work, clearing up as much debris as it can while secreting proteins that attract immune system cells to the wound, further accelerating tissue repair. This phase is commonly associated with edema, heat, and pain and lasts for about 4 to 6 days.

Phase 3: The Proliferative Phase

By this time, the wound should have already cleared out and would now be entering the third phase of the wound healing process called the proliferative phase.

This phase can be broken down further into three substages:

  1. Filling the wound

  2. Contraction of the wound margins

  3. Covering the wound or epithelialization

The first stage is characterized by shiny, deep red granulation tissue that fills the wound bed with connective tissue while new blood is being formed. The wound margins would then contract and converge toward the center of the wound in the second stage and begin to get covered with epithelium as it reaches the third stage. This stage usually lasts anywhere from 4 to 24 days.

Phase 4: The Maturation Phase

Last but not least is the maturation phase where new tissue gradually gains strength and becomes more flexible. In this phase, collagen fibers start to reorganize as tissue also begins to remodel and mature. This phase varies for every wound and may last for as quick as 21 days or as long as two years.

As you can imagine, the wound healing process is quite remarkable though it cannot be absolute because of the different factors that can interfere like age, body type, moisture, or maceration, just to name a few.

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